Blood transfusion apparatus



Feb. 1.1, 1936. s. MEEKER BLQOD TRANSFUSION APPARATUS 2 Sheets-Sheet` 1 Filed Oct. l2, 1953 Feb. 11, 1936. s. MEEKER BLOOD TRANSFUSION APPARATUS Filed Oct. l2, 1933 2 Sheets-Sheet 2 NW UN Nn wud Nv Patented Feb. 1l, 1936 UNITED STATES PATENT OFFICE 4 Claims.

This invention relates to improvements in apparatus for the continuous transfusion of blood, and is specifically directed to improving the apparatus disclosed in my U. S. Patent No. 1,973,351, dated Sept. 1l, 1934.

One of the objects of the invention is to provide an apparatus for this purpose having a single valve for use in vcontinuously transferring blood from the donor to the recipient, and provided with means for furnishing a saline solution to the recipient when necessary to prevent clotting, and to keep the recipients needle in unobstructed condition. i

During a blood transfusion, there are usually two important causes for the formation of brin in the blood, often resulting in a blood clot, and this fibrin and/or blood clot tends to gather in the needle of the recipient, and may finally block said needle. The rst and most important cause for the above diiiculty is due to the crushing and rupturing of the corpuscles of the blood by the sliding action of the. plunger on the barrel of the ordinary syringe. It is therefore one of the obe jects of my invention to eliminate this first imf portant cause by providing a syringe constructed of two cylinders (preferably made of glass) that telescope and are ground to fit" to prevent the escape of air between their surfaces. One end of each cylinder has a hollow tip. The inner cylinder is known as the barrel and the outer cylinder as the plunger. The tip of the outer cylinder is closed by a solid cap. In operation, the air in the cylinders acts as an (invisible) "air piston. 'Ihe blood simply rises and fallsin the barrel cylinder when acted upon by the air piston.

Y Such a syringe will pump blood from the donor to the recipient without liability of forcing fibrin from the'syringe to the needle ofthe recipient.

The second important cause for the formation of fibrin in the blood, and the subsequent blood clot, is due to slowing down or stopping of the blood stream from the donor to the recipient. "It is therefore a further object of my invention to eliminate this second difculty by providing an apparatus of this character, including the above mentioned type of syringe which may continuously pump the blood from the donor to the recipient without slowing down or stopping of the blood stream.

A still further object is to supply a blood transfusion apparatusincluding syringes of the above character which may be used either for continuous or intermittent operation. Y

With the foregoing objects outlined and with other objects in View which will appear the (Cl. 12S- 214) description proceeds, the invention consists in the novel features hereinafter described in detail, illustrated in the accompanying drawings, and more particularly pointed out in the appended claims. 5

In the drawings, Fig. 1 is a horizontal sectional view partly in elevation, of the improved continuous apparatus with certain parts removed to facilitate illustration, and showing the valve in the position in l0 which blood is being drawn into the apparatus from the donor by a rst syringe, and being forced to the recipient by a second syringe.

Fig. 2 is a similar view of a modification showing the valve in the position it occupies while l5 blood is being drawn from the donor by the second syringe, and is being forced to the recipient by the first syringe.

Fig. 3 is a vertical sectional view taken through the valve or central portion `of the apparatus to illustrate the means for feeding a saline solution to the needle of the recipient.

Fig. 4 is a view similar to Fig. 1, but showing the apparatus modified for intermittent operation. 25

Referring to Figs. 1 and 3 of the drawings, II) designates a valve casing having a vertically disposed frusto-conical bore I I, from which ports I2,

I3, I 4 and I5 lead, preferably horizontally, to the exterior of the casing. These ports in this exam- 30 ple, are arranged at degrees relatively to one another, Aand each terminates in a nipple I6. Flexible tubes I'I are connected to the nipples of the ports I2 and I4 and are also joined to nipples I8 which form part of the nozzles I9 of special syringes 20 and 2|.

In conventional type syringes, i. e., one having the plunger inside the barrel heretofore used in blood transfusion apparatus, a very thin ilm of blood is deposited on the wan of the barrel as the 40 plunger moves outwardly. Part of this film is scraped off as the plunger is pushed in, and a microscopic (so to speak) part of the film enters between the plunger and the barrel, and the blood cells become crushed. Fibrin is formed in these crushed blood cells, and it accumulates, thus causing the plunger to stick. The plunger may stick after three or four strokes of the piston. With each stroke, a portion of the fibrin is scraped or pushed olf the wall of the barrel and is carried on to; the needle of the recipient where it may gather in the lumen of the needle. Perfect bloody transfusion is thus prevented, and enough fibrin can accumulate tof clog theneedle. Therefore, I have combined with a blood trans- 0 Vof blood will accumulate on'the wall of the barrel and form fibrin. ,Howeven thisy sticks or clings to the wall, and is not scraped or pushed ofi to pass on to the needle to plug it.

As illustrated,v in Fig. 1, each of these air suction-pressure type syringes may consist of a barrel 22 having a hand engaging portion 23 at one end thereof forming a stop'shoulder 24. The plunger 25 in this instance is of substantially cup-shape, and reciprocates with a ground lit on the outer surface of the barrel 2.2'.

A stopper or partition 25 isV provided at the outer end o-f the barrel and has a peripheral groove or hole 21 to permit air to travel from the interior of the barrel to the interior of the plunger, and vice versa. The. hole or groove 21 is preferably placed at the upper portion of the stopper sol as to prevent any blood drawn into the barrel from accidentally spilling into the plunger chamber.

The plunger, stopper and barrel may be made of any suitable material, but I prefer to form the same of transparentv glass, and to provide either theY barrel or plunger with calibrations 28 which'function as indicators of the amount of blood drawn into the barrel.

YDuring the continuous opeartion Vof such an apparatus, the plunger of each syringe is to be moved in Vone direction for drawing blood into its barrel from the donor, while the plunger of the other syringe is moved in the opposite direction to force blood from its barrel to the recipient.

Referring again to the valve casing, it will be noted that the nipple of the'port l5 is connected to one end of a flexible tube 29, and the opposite end of said tube has a conventional nipple that is to be connected to Vthe donors needle (not shown). The nipple of port I3 is connected to a flexible tube 3| having a nipple 32 for use in connecting the same to the recipients needle V(not shown). The continuous flow of blood from the donor to the recipient by means of the syringes, is controlled by a manually operated tapered valve plug 33 which is arranged to oscillate in the bore of the casing I5, and is manipulated by means of a handle 34 which projects fromthe plug and cooperates with stop surfaces 35 and 3S on the casing which limit the movement of the handle. Passageways 31 and 38 for the passage of blood only extend horizontally through the plug andY have their ends positioned 90 degrees apart soas to properly cooperate with the portsV |21 to` 15 inclusive. Y

When the valve plug 33 is in the position shown in Fig. l, blood may be drawn from the donor by the syringe 2i through the donors needle, and Y parts 3|), 29, l5, 31, I4, 11 and I8, into the barrel of the syringe 2l, while bloodfrom the syringe 20 will -be forced through i9, 18, l1', l2, 3&1, 13,3! and 32, through the recipients needle, into the recipient.V Y

When the barrel o-f the syringe 26 has been emptied, the operator turns the handle 34 into the position shown in Fig. 2, and then blood from the syringe 2|a will be forced to the recipient. while blood from the donor will be drawn into the syringe 25a in a manner which will be obvious from the foregoing description.

-ond chamber.

fusion instrument, special air suction-pressure In order to hold the valve plugin working position, I preferably ,provide the valve casing with an upstanding post 40 which supports one end of a leaf spring 4l that may be adjustably pressed aga-inst the top of the plug by a hand nut 42 threaded on the post, Y

The valve casing may be supported in any suitable way, but I prefer to mount it on a base 43 which can rest on a table'between the arms of theV donor and recipient, and the valve casing may be locked to the base by any suitable. means, such as a thumb screw 44.

For the purpose of introducing (preferably by gravity) a saline solution or the like when necessary, into the needle of the recipient, I place such a solution in a receptacle 45 (Fig. 3) which may be removably suspended'by a wire bail 46 supported by a vertically adjustable post 41 held in adjusted positions in a rigid tube 48 by a thumb screw 49. The tube is supported by the base 49a.

A flexible tube 50 at the lower end of the receptacle 45 supports a hand operated clamp valve 5I which may be manipulated to release the saline solution into a flexible tube 52 that has a nipple 53 which projects downwardly into a countersunk hole 54 in the valve plug. This hole communicates with an L-shaped passageway 55 ofthe plug for thepassage of a saline solution only or the like, and when the plug is in the position shown in Fig. 3, saline solution from the receptacle 45 can be introduced through the port I3 and tube 3| into the recipients needle.

A-s the tube 52 is flexible, and the plug is moved only a short distance in operation, it is obvious that when the plug is turned, the joint between the nipple 53 and plug will not be broken.

With reference to this feature of the invention, it may be stated that the use of the saline solution given at proper times through the recipients needle, will keep the latter open and prevent brin from accumulating vand interfering with the operation of the apparatus.

Instead of making the syringes as illustrated Y' plunger is drawn outwardly, it will draw air from Y one chamber into another, and this will cause fthe entrance of blood into the rst chamber, but will prevent the blood from travelling to the sec- Consequently, even if fibrin is The barrel of the regular Luer type deposited on the wall of the barrel, it will simply stick there and will not be forced to the recipients needle. Y

In operation, the donor and rec-ipientV are placed parallel, with a table between them, and

the table will be large enough so that Van arm of each and the transfusion instrument can be placed upon it. Then a sphygomanometer is placed on an arm of Veach. At the proper time, the pressure is raised high enough above Vthe diastolic pressure of each lso as to fill the VveinsV for the insertion of the needle or canula. During the transfusion, the pressure on the arm of the donor is kept 10 to 30 points above the diastolic pressure.

A hand and forearm of each should then be wrapped in a sterile towel, and the usual other sanitary precautions should be resorted to. After the transfusion apparatus has been properly assembled and sterilized, a vein of the recipient is the first to be connected to the apparatus. 'I'hen a needle or canula is inserted in a vein of the donor, and the transfusion is ready to begin. At this time, one or the other of the syringes is operated to withdraw blood from the donor, and if the parts are in the position shown in Fig. 1,

such blood will be withdrawn by means of syringes 2|. Then the valve plug 33 is shifted to the position shown in Fig. 2, and syringe 2| (2 Ia) is used to force the blood from its barrel to the recipient while the syringe 2|] (20a) is operated to withdraw blood from the donor into the barrel of the syringe 20 (20a).

Experience has demonstrated that the needle in the vein of the recipient is the only partof the instrument that is liable to become clogged during continuous transfusion with this instrument. The following procedure prevents this. If the handle 34 is turned so as to move the Valve plug into the position shown in Fig. 3, and the valve 5| is opened at this time, within three to five seconds, enough normal saline solution will be permitted to ow automatically by gravity from the container 45 into the tubing 3| to free the recipients needle of any accumulating fibrin. It is seldom necessary to do this oftener than after the injection of every second or third syringe full of blood.

By the use of the apparatus, 300 c. c. to 700 c. c. of blood can be given in from six to ten minutes. The rate of speed will depend on any reaction of the recipient to the transfusion.

After a determined amount of blood has been given, it is sometimes advisable to add more fluid to the blood stream, such as a normal saline solution, glucose solution or other uid. This can be readily accomplished by the present apparatus by removing the needle from the vein of the donor and rotating the valve into the position shown in Fig. 3, so that any desired quantity of fluid will then flow by gravity into the vein of the recipient.

From the foregoing it will be appreciated that I have devised relatively simple means for giving continuous blood transfusions by an instrument comprising a single valve which controls both the movement of the blood and the introduction of a saline solution or the like, and by special syringes which will prevent fibrin being forced to the needle of the recipient. Suchspecial features will function to permit the instrument to be continuously operated, for continuous transfusion is impossible if any passageways of the instrument become clogged during the operation.

The apparatus described can be readily converted into an intermittently operating one by removing the syringe 20 (Fig. 1) closing the port |2a of the valve casing by means of a cap |2b and substituting valve plug 33a for valve plug 33. In this instance, when the valve plug 33a is in the position shown in Figs. 1 and 4, and the plunger 25a of the single syringe 2|b is drawn outwardly, blood will be drawn from the donor through the tube 29*l into the syringe and at the same time the normal saline solution will be owing through L shaped port 55a and tube 3 |a to the needle of the recipient. When the valve plug 33El is shifted to the position shown in Fig. 2 and the plunger is moved towards its barrel, the blood Will be forced through the tube 3|a to the recipient, and the L shaped port 55a will be blocked by the cap |211, in a manner manifest to those versed in the art.

While I have disclosed what I now consider to be the preferred embodiments of the invention in such manner that the same may be readily understood by those skilled in the art, I am aware that changes may be made in the details disclosed, without departing from the spirit of. the invention, as expressed in the claims.

What I claim and desire to secure by Letters Patent is:

1. In an apparatus of the character described, a passageway adapted to place the veins of the donor and recipient'in communication, a plurality of syringes, a shiftable valve joining said syringes and interposed in said passageway to allow blood to be fed from the donor to the recipient when the valve is ina certain position, and means controlled by the same valve for introducing a clotting preventative into the. veins of the recipient independently of said syringes when the valve is in a different position.

2. In an apparatus of the character described, a passageway adapted to place the veins of the donor and recipient in communication, a plurality of syringes, a shiftable valve joining said syringes and interposed in said passageway to allow blood to be continuously fed from the donor to the recipient, and means controlled by the same valve for introducing a clotting preventative into the veins of the recipient independently of said syringes.

3. In an apparatus of the character described, a passageway adapted to place the veins of the donor and recipient in communication, a plurality of syringes, a shiftable valve joining said syringes and interposed in said passageway to allow blood to be fed from the donor to the recipient when the valve is in a certain position, and means controlled by the same valve for introducing a clotting preventive into the veins of the recipient independently of said syringes when the valve is in a diierent position, each of said syringes comprising a barrel having an air passageway at one end thereof, and a plunger positioned exteriorly of the barrel and adapted to operate to cause air to travel through said air passageway for drawing blood into the barrel and forv discharging blood from the barrel without permitting the blood to flow through said air passageway.

4. In an apparatus of the character described, a rst passageway adapted to place the veins of the donor and recipient in communication, a plurality of syringes, a shiftable valve joining said syringes and interposed in said passageway to allow blood to be fed from the donor to the recipientwhen the valve is in a certain position, and a second passageway arranged in the same valve and controlled thereby for introducing a clotting preventative into the veins of the recipient independently of said syringes when the valve is in a different position.

SIDNEY MEEKER.V 

